News of a pancreatic cancer breakthrough spread quickly through the oncology community when researchers recently shared phase 3 trial results showing that a new, investigational drug doubled survival for the sickest patients compared with standard-of-care chemotherapy.
But the survival benefit is only part of what makes the study so promising, said Vincent Chung, M.D., a medical oncologist at City of Hope.
“These results mark a turning point in the effort to achieve cures for pancreatic cancer,” Dr. Chung said. “By delivering the first targeted therapy for the disease, this study opens the door to additional treatments that could further improve outcomes.”
City of Hope was among 59 centers worldwide that enrolled patients in the phase 3 clinical trial of the experimental targeted drug daraxonrasib. Researchers presented their findings at the 2026 American Society of Clinical Oncology (ASCO) Annual Meeting, where the results were hailed as a game-changer for pancreatic cancer.
The results of the clinical trial were so positive that the U.S. Food and Drug Administration quickly approved an expanded access treatment protocol (EAP), through which City of Hope will provide early, pre-FDA-approved access to the drug to patients with previously treated metastatic pancreatic cancer.
A New Type of Pancreatic Cancer Therapy
Pancreatic cancer is a highly aggressive disease with the worst survival rate of any major cancer. The only current treatment is cytotoxic chemotherapy, which not only kills cancer cells but also healthy cells. This approach causes severe side effects with only modest improvement in survival.
Daraxonrasib, which is taken as a daily pill, is a different type of treatment called a targeted therapy. Instead of attacking all replicating cells in the body, it targets cancer cells specifically by homing in on a gene mutation called KRAS, which is found in 90% of pancreatic cancers. The result is that daraxonrasib is more effective at stopping cancer growth with far fewer side effects.
In the trial, patients with metastatic pancreatic cancer who had previously failed chemotherapy were split into two groups. One group received daraxonrasib, while a second group continued standard chemotherapy. The patients on daraxonrasib survived a median 13.2 months, compared with 6.7 months for those treated with chemotherapy.
Reaching Patients with Expanded Access
The EAP has generated tremendous interest.
“Patients have been tracking the phase 3 clinical trial’s data and asking us about the therapy,” said Pashtoon Kasi, M.D., medical director of GI medical oncology at City of Hope Orange County. “They’re ecstatic and grateful that they will be able to get this sooner rather than later.”
Last year, City of Hope became the first academic center to launch a national clinical trials model, which expands access to emerging cancer treatments to patients nationwide. The model, which streamlines patient enrollment in trials at City of Hope locations across the country, will make it quicker and easier for patients to access daraxonrasib under the EAP.
While the EAP is intended to grant early access to the drug on compassionate grounds, patients must still meet certain criteria in order to qualify, Dr. Chung noted. Patients should talk with their doctor about their eligibility, he said.
Improving Quality of Life
While survival outcomes have received the most attention, daraxonrasib’s impact on patient quality of life might be just as important, Dr. Kasi said.
Chemotherapy may extend patients’ lives by a few months, but it doesn’t improve cancer symptoms, including severe pain. It also causes toxic side effects that can make patients’ quality of life even worse. Because of this, many patients with advanced pancreatic cancer don’t even attempt treatment, deciding it’s not worth it, Dr. Kasi noted.
“There’s a lot of treatment nihilism,” he said. “Many patients just go directly to hospice.”
But in the trial, patients on daraxonrasib experienced significant relief within days, including rapid improvements in pain, appetite and overall quality of life. Some patients were able to stop taking pain medication entirely, while others who had been on disability returned to full-time work.
“The trial numbers don’t capture the patient experience in its entirety,” Dr. Kasi said. “The improvements we saw in patient well-being was something that was unparalleled and heartening to see.”
“The Gift of Tomorrows”
Those patients included Patricia Andrews, an ICU nurse from Tustin, California, who enrolled in the trial under Dr. Kasi’s care. Within weeks of starting daraxonrasib, her tumor markers dropped significantly. She was able to function normally and maintain her daily activities for around 10 months on the treatment.
“Without a doubt, this trial changed my life,” Andrews said. “I’m grateful to City of Hope and Dr. Kasi for giving me the gift of tomorrows so I can stay focused on healing, living life to the fullest and spending as much time as possible with my kids and grandkids.”
Dr. Kasi noted that daraxonrasib is not without side effects, which can include skin rashes and inflammation. However, the side effects are far milder than chemotherapy, and they can be managed with proactive treatment and by partnering with dermatologists and other experts, he said.
A Foundation for New Treatment Strategies
Beyond improving quality of life for patients, daraxonrasib could open new treatment options to help patients live even longer than they did in the study.
Currently, patients with inoperable pancreatic cancer are treated with one chemotherapy after another, but side effects are so severe that doctors often need to reduce the dose or even delay treatment until patients are strong enough to endure more therapy.
Adding daraxonrasib to the sequence of treatments could “reset the clock” and give the body time to recover, allowing the patient to continue subsequent therapies at the optimal dose, achieving better results, Dr. Chung said.
And while the first trials of daraxonrasib have been as a second-line therapy in the sickest patients, studies now underway are looking at providing it to study participants much earlier, with promising results, he said.
If daraxonrasib could help shrink tumors in patients whose cancer hasn’t yet spread, for example, it might help previously inoperable patients qualify for surgery, which is the only current treatment with the potential to actually cure pancreatic cancer.
Daraxonrasib also has potential applications in other types of cancer, Dr. Kasi added, noting that the KRAS mutation is also common in colorectal cancer, breast cancer, ovarian cancer and many others.
“We were honored and grateful to be a part of this story that was more than a decade in the making,” he said.
A Transformational Gift
City of Hope has long been a leader in pancreatic cancer care and research. In 2024, that work gained new momentum with a $150 million gift from philanthropists A. Emmet Stephenson Jr. and Tessa Stephenson Brand to help speed progress against one of the deadliest cancers.
The gift launched the Stephenson Global Pancreatic Cancer Research Institute (SGPCRI), a worldwide effort focused on advancing new ideas and bringing researchers together to move discoveries forward faster. It also established the $1 million Stephenson Global Prize, which honors scientists whose work has changed how we understand and treat pancreatic cancer.
The first recipient, Frank McCormick, Ph.D., helped lay the groundwork for targeting KRAS, a key driver in many cancers. Today, that foundation is paying off with advances like daraxonrasib, a next-generation therapy that is already improving outcomes for patients.
“The daraxonrasib results are very remarkable, especially in a second-line setting,” said Daniel Von Hoff, M.D., chair of the Stephenson Scientific Advisory Board. “These findings are reinvigorating the entire field and giving much-needed hope to patients.”
Progress like this shows how transformative, long-term investment in science can lead to real change for patients. By supporting bold ideas and collaboration, City of Hope is helping move pancreatic cancer research toward earlier detection, better treatments and, ultimately, a cure.